Drug Interaction: Isosorbide mononitrate is known to interact with other drugs like avanafil, dihydroergotamine, dihydroergotoxine, ergonovine, methylergonovine, sildenafil, telithromycin, udenafil, voriconazole. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Mechanism of Action: Isosorbide mononitrate is converted to nitric oxide (NO), an active intermediate compound which activates the enzyme guanylate cyclase (Atrial natriuretic peptide receptor A). This stimulates the synthesis of cyclic guanosine 3',5'-monophosphate (cGMP) which then activates a series of protein kinase-dependent phosphorylations in the smooth muscle cells, eventually resulting in the dephosphorylation of the myosin light chain of the smooth muscle fiber. The subsequent release of calcium ions results in the relaxation of the smooth muscle cells and vasodilation.

Pregnancy Impact: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Impact During Lactation: There are no controlled studies in breastfeeding women, however the risk of untoward effects to a breastfed infant is possible; or, controlled studies show only minimal non-threatening adverse effects. Drugs should be given only if the potential benefit justifies the potential risk to the infant.

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In compliance with Drug and Cosmetic Act and Rules, we don't process requests for Schedule X and other habit forming drugs. For Schedule H and H1 drugs a valid prescription from a registered medical practitioner needs to be uploaded with Order.